Impact of vision loss on costs and outcomes in medicare beneficiaries with glaucoma

Arch Ophthalmol. 2008 Jun;126(6):849-56. doi: 10.1001/archopht.126.6.849.


Objective: To assess the impact of vision loss severity on costs and health outcomes among Medicare beneficiaries with glaucoma.

Methods: A retrospective cohort analysis was conducted using Medicare claims. Patients were stratified into 4 categories: no vision loss, moderate vision loss, severe vision loss, and blindness. Outcomes of interest were mean annual medical costs by category, component costs, and frequency of depression, falls and/or accidents, injury, femur fracture, and nursing home placement.

Results: Multivariate regression analysis showed that patients with any degree of vision loss had 46.7% higher total costs compared with patients without vision loss. Mean total and component costs increased with onset and severity ($8157 for no vision loss to $18,670 for blindness). Patients with vision loss were significantly more likely to be placed in a nursing home (odds ratio = 2.18; 95% confidence interval, 2.06-2.31), develop depression (odds ratio = 1.63; 95% confidence interval, 1.54-1.73), fracture a femur (odds ratio = 1.67; 95% confidence interval, 1.53-2.83), or experience a fall or accident (odds ratio = 1.59; 95% confidence interval, 1.50-1.68) vs patients without vision loss.

Conclusions: Vision loss in glaucoma is costly, and costs increase with severity. There is significantly increased risk of nursing home admission, depression, falls and/or accidents, injury, or femur fracture with vision loss compared with no vision loss.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Depression / etiology
  • Female
  • Femoral Fractures / etiology
  • Glaucoma / complications*
  • Glaucoma / economics*
  • Health Care Costs*
  • Humans
  • Institutionalization
  • Male
  • Medicare*
  • Nursing Homes
  • Retrospective Studies
  • Severity of Illness Index
  • United States
  • Vision Disorders / complications
  • Vision Disorders / economics*
  • Vision Disorders / etiology
  • Vision Disorders / physiopathology*